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Esophagogastric devascularization without splenectomy in portal hypertension: safe and effective? |
Yan-Bin Ni, Peng-Ji Gao, Dong Wang, Zhao Li and Ji-Ye Zhu |
Beijing, China
Author Affiliations: Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044, China (Ni YB, Gao PJ, Wang D, Li Z and Zhu JY)
Corresponding Author: Ji-Ye Zhu, MD, Department of Hepatobiliary Surgery, Peking University People's Hospital, Beijing 100044, China (Tel/Fax: +86-10-68310585; Email: gandanwk@vip.sina.com) |
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Abstract BACKGROUND: Esophagogastric variceal hemorrhage is a life-threatening complication of portal hypertension. In this study, we compared the therapeutic effect of a novel surgical procedure, esophagogastric devascularization without splenectomy (EDWS), with the widely used modified esophagogastric devascularization (MED) with splenectomy for the treatment of portal hypertension.
METHODS: Fifty-five patients with portal hypertension were included in this retrospective study. Among them, 27 patients underwent EDWS, and the other 28 patients underwent MED. Patients' characteristics, perioperative parameters and long-term follow-up were analyzed.
RESULTS: The portal venous pressure was decreased by 20% postoperatively in both groups. The morbidity rate of portal venous system thrombosis in the EDWS group was significantly lower than that in the MED group (P=0.032). The 1- and 3-year recurrence rates of esophagogastric variceal hemorrhage were 0% and 4.5% in the EDWS group, and 0% and 8.7% in the MED group, respectively (P=0.631).
CONCLUSIONS: EDWS is a safe and effective treatment for esophagogastric varices secondary to portal hypertension in selected patients. Patients treated with EDWS had a lower complication rate of portal venous system thrombosis compared with those treated with conventional MED.
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